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电针预处理对老年患者术后认知功能障碍的影响:一项前瞻性、随机、对照试验。

Effects of preconditioning of electro-acupuncture on postoperative cognitive dysfunction in elderly: A prospective, randomized, controlled trial.

作者信息

Zhang Qi, Li Ya-Nan, Guo Yang-Yang, Yin Chun-Ping, Gao Fang, Xin Xi, Huo Shu-Ping, Wang Xiu-Li, Wang Qiu-Jun

机构信息

Department of Anesthesiology, the Third Hospital of Hebei Medical University, No.139, Ziqiang Road, Shijiazhuang City, Hebei, China.

出版信息

Medicine (Baltimore). 2017 Jun;96(26):e7375. doi: 10.1097/MD.0000000000007375.

Abstract

Electro-acupuncture is a burgeoning treatment using the needle inserting into the body acupoints and the low-frequency pulse current being electrified by an electric acupuncture machine. This study was designed to evaluate the effects of preconditioning of electro-acupuncture on postoperative cognitive dysfunction in elderly.Ninety patients scheduled spine surgery were randomly assigned into 2 groups using a random number table: control group (group C) and electro-acupuncture group (group EA). In group EA, electro-acupuncture was applied on Baihui, Dazhui, and Zusanli acupoints 30 minutes before anesthesia. At 0 minute before treatment of electro-acupuncture, 1 hour after skin incision and surgery completed (T1-3), blood samples were taken for detection of interleukin (IL)-6, IL-10, and S100β by enzyme-linked immunosorbent assay. The total dose of remifentanil and propofol during surgery were recorded. Mini-Mental State Examination was applied to evaluate the cognitive function of patients at 1 day before surgery and 7th and 30th day after surgery.The results showed that compared with group C, score of MMSE increased after surgery, the serum concentration of IL-6, IL-10, and S100β decreased at 1 hour after skin incision, and surgery completed in group EA. Moreover, the total dose of remifentanil and propofol reduced during surgery in group EA.The present study suggests that preconditioning of electro-acupuncture could improve the postoperative cognitive function, and the reduction of inflammatory reaction and brain injury may be involved in the mechanism.

摘要

电针是一种新兴的治疗方法,通过将针刺入人体穴位,并利用电针仪施加低频脉冲电流。本研究旨在评估电针预处理对老年患者术后认知功能障碍的影响。90例计划行脊柱手术的患者使用随机数字表随机分为两组:对照组(C组)和电针组(EA组)。EA组在麻醉前30分钟对百会、大椎和足三里穴位进行电针治疗。在电针治疗前0分钟、皮肤切开后1小时及手术结束时(T1-3),采集血样,采用酶联免疫吸附测定法检测白细胞介素(IL)-6、IL-10和S100β。记录手术期间瑞芬太尼和丙泊酚的总剂量。采用简易精神状态检查表评估患者术前1天、术后第7天和第30天的认知功能。结果显示,与C组相比,EA组术后简易精神状态检查表评分升高,皮肤切开后1小时及手术结束时血清IL-6、IL-10和S100β浓度降低。此外,EA组手术期间瑞芬太尼和丙泊酚的总剂量减少。本研究表明,电针预处理可改善术后认知功能,其机制可能与炎症反应和脑损伤的减轻有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17b2/5500085/77ba09658a29/medi-96-e7375-g001.jpg

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